Aetna marketplace plans
In 2017, we’re offering plans on the health insurance marketplace, or exchange, in the following states: Delaware, Iowa, Nebraska and Virginia.
After January 31, you can’t enroll in a plan for 2017 unless you qualify for a special enrollment period.
Different plans, different needs
All plans available in the Health Insurance Marketplace are separated into metal levels. The levels are bronze, silver, gold and platinum.
A plan’s level indicates roughly how much you will need to pay for premiums and out-of-pocket costs. The metallic plan levels make finding the right plan easier. They help you understand your costs. For example, a bronze plan will have higher out-of-pocket costs, but a low monthly premium. A platinum plan will have lower out-of-pocket costs, but a higher monthly premium.
There are limits to how much you will pay out of pocket. With any plan, once you have reached this limit, the insurance company pays 100% of your costs for covered care.
|% of essential benefit costs covered by plan in a typical year*||60%||70%||80%||90%|
|Monthly premium||Lowest premium costs without sacrificing quality of coverage||Balanced plans with lower premiums and average out-of-pocket costs||Higher premiums and lower out-of-pocket costs||Highest premiums, but very low out-of-pocket costs|
|Out-of-pocket maximums for all plans||Individual plans: $7,150
Family plans: $14,300
*However, the plan may pay a higher or lower percentage of the total costs of covered services for the year, depending on your actual health care needs and the terms of your insurance policy.
The Affordable Care Act and you
Congress passed the Affordable Care Act (ACA) in 2010. The ACA created guidelines for the public Health Insurance Marketplace. It also:
- Requires most people to have health coverage or possibly face a tax penalty
- Offers some people help to pay for their health coverage
- Prohibits insurers from denying coverage or charging more based on your health status or pre-existing conditions
- Requires that most health plans cover preventive services at no charge to you
- Requires that you receive a summary of your benefits in plain language
- Allows young adults to stay on their parents' plans until age 26
Aetna Health Plans for Individuals, Families and the Self-Employed are underwritten by Aetna Life Insurance Company. Aetna Health Plans (HMO) are underwritten by Aetna Health Inc. (“Aetna” refers to Aetna Life Insurance Company and/or Aetna Health Inc.). In some states, individuals may qualify as a business group of one and may be eligible for guaranteed issue, small group health plans.
This material is for information only. Health benefits and health insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change.
Note: This information is not meant as legal or tax advice. Please talk to your legal or tax advisor about any questions.